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PubMedDate not supplied

Improved quantification of left ventricular function by applying signal averaging to echocardiographic acoustic quantification.

The acoustic quantification technique for on-line detection of endocardial boundaries currently provides continuous left ventricular area or volume signals and beat-to-beat ejection fraction. However, the distortion of individual waveforms by noise results in a wide beat-to-beat variability in these parameters. We developed an automated algorithm for the evaluation of left ventricular function by averaging acoustic quantification signals. End-diastolic and end-systolic area, stroke area, and fractional area change are measured directly from the average waveform. Peak ejection and peak filling rates and time to peak filling rate are obtained from its time derivative. Area signals obtained from eight normal subjects were used to evaluate the performance of this algorithm. Parameters of left ventricular function obtained with the automated algorithm were highly consistent and in excellent agreement with those obtained by repeated manual operator-dependent selections. This algorithm provides a fast and easy method for noise reduction in acoustic quantification signals, which significantly improves the noninvasive assessment of left ventricular function.

Acoustics↗

PubMed2001

Left ventricular function and infarct size 20 months after primary angioplasty for acute myocardial infarction.

OBJECTIVE: To study changes in left ventricular function and infarct size during long-term follow-up after acute myocardial infarction treated with primary angioplasty. DESIGN: From 1996 to 1998, 100 consecutive patients were treated with primary angioplasty for acute ST-elevation myocardial infarction. Angioplasty was successful in 95% of the patients. Global left ventricular ejection fraction (LVEF) was determined by radionuclide ventriculography before discharge, after 6 weeks and after a mean follow-up time of 20 months. Infarct size was assessed by technetium 99m-tetrofosmin myocardial perfusion tomography (SPECT) at rest, performed at the same time intervals. RESULTS: Mean LVEF was 56% at discharge, 55% after 6 weeks and 57% after 20 months of follow-up. No significant improvement in LVEF was observed. Only 8% of the patients at follow-up had LVEF lower than 40%. After 1 week, a mean perfusion defect of 19% was measured by SPECT. After 6 weeks and 20 months of follow-up, the mean perfusion defects were reduced to 14% (p < 0.001) and 15%, respectively. CONCLUSION: Left ventricular function was well preserved with a mean LVEF of 57% 20 months after primary angioplasty for acute myocardial infarction. No significant change in LVEF was observed from 1 week after angioplasty to follow-up. Infarct sizes as assessed by SPECT imaging with tetrofosmin were reduced from 1 to 6 weeks, but did not change further during long-term follow-up. The reduction in the perfusion defects over time was probably due to gradual relief of stunning.

Angioplasty, Balloon, Coronary↗

PubMedDate not supplied

Postexercise left ventricular function: a comparative assessment by different noninvasive imaging modalities.

The variety of noninvasive imaging modalities now available permits assessment of different aspects of left ventricular function in the postexercise state. Some of these modalities, such as first-pass radionuclide ventriculography, permit a nearly instantaneous assessment of left ventricular function in the early postexercise state. These modalities indicate that most exercise-induced left ventricular wall motion abnormalities resolve quickly after exercise. Resting wall motion abnormalities may also improve in the postexercise period; this response indicates the presence of hibernating myocardium capable of improving in response to myocardial revascularization procedures. On the other hand, all imaging techniques indicate that a certain percentage of exercise-induced wall motion abnormalities may persist into the postexercise period, and this finding signifies that severe coronary disease subtends the region of persisting wall motion abnormality. Further, if there is increased left ventricular size after exercise, both extensive and severe coronary disease are present. A conceptual framework for unifying these disparate findings is provided. These results underscore the importance of postexercise imaging in enhancing clinical assessment and imply that there are important technical considerations to contemplate when performing certain tests such as postexercise echocardiography.

Echocardiography↗

PubMed1996

[Usefulness of 123I-BMIPP myocardial scintigraphy for evaluation of the left ventricular function in patients with chronic heart failure].

We examined the relationship between free fatty acid metabolism using 123I beta-methyl-iodophenyl-pentadecanoic acid (BMIPP) and cardiac function in patients with chronic heart failure (CHF). Cardiac free fatty acid metabolism was evaluated by the heart to mediastinum ratio (H/M), the heart to lung ratio (H/Lu), the heart to liver ratio (H/Li) and the myocardial uptake ratio (MUR) obtained from the planar imaging. Cardiac function was evaluated by the percent of fractional shortening (%FS) and the amount of left ventricular mass (LV mass) calculated with echocardiography. The study included 34 male and 14 female subjects of CHF with mean age of 61 +/- 9 years; dilated cardiomyopathy (DCM): n = 17, ischemic heart disease (IHD): n = 16, valvular disease: n = 5, hypertrophic cardiomyopathy: n = 4, hypertension: n = 4, amyloidosis: n = 2. The correlations between indices of BMIPP uptake and those of echocardiography were as follows: H/M vs. %FS (r = 0.67, p < 0.01), H/Lu vs. %FS (r = 0.49, p < 0.01), H/Li vs. %FS (r = 0.12, p = 0.42), MUR vs. %FS (r = 0.03, p = 0.86) and MUR/LV mass vs. %FS (r = 0.59, p < 0.01). The correlation coefficient between H/M and MUR/LV mass in patients with IHD was higher than that in patients with DCM. In conclusion, BMIPP, in particular, is a useful tool for evaluating cardiac function in patients with CHF.

Aged↗

PubMed1995

Prospective study of left ventricular function after radiofrequency ablation of atrioventricular junction in patients with atrial fibrillation.

BACKGROUND: In patients with drug resistant incessant supraventricular tachycardia, radiofrequency induced ablation of the atrioventricular junction and pacemaker implantation have hitherto been considered a treatment of last resort. OBJECTIVE: To assess the short and long term effects of ablation of the atrioventricular junction on systolic and diastolic left ventricular function in patients with atrial fibrillation with and without impaired left ventricular function. PATIENTS: 29 patients (19 men; mean age 65 (SD 7) years (range 50-76)) undergoing ablation of the atrioventricular junction for drug refractory atrial fibrillation were examined a mean of 2, 65, and 216 days after ablation of the bundle of His. MAIN OUTCOME MEASURES: Left ventricular ejection fraction and early filling deceleration times (Edec) were assessed by Doppler echocardiography after 1 to 2 hours of ventricular pacing at a rate of 80 beats/minute. RESULTS: In 14 patients with a left ventricular ejection fraction < 50% left ventricular ejection fraction increased significantly from 32% (11%) to 39% (11%) (65 days) and 45% (11%) (216 days) (P < 0.001); Edec increased from 142 (46) ms to 169 (57) ms (65 days) and 167 (56) ms (216 days) (P < 0.05). In 15 patients with an ejection fraction > or = 50% at the initial examination no significant change in systolic function was observed. CONCLUSIONS: In patients with left ventricular dysfunction long term improvement of systolic and diastolic left ventricular function was seen after ablation of the atrioventricular junction for rate control of atrial fibrillation. This procedure had no adverse effects on normal left ventricular function.

Aged↗

PubMed1986

[Echocardiography evaluation of left ventricular function in mitral valve stenosis].

It is reported on results of echocardiographic investigations concerning the left ventricular function in 60 patients with mitral stenosis (30 patients in stage II, 30 patients in stage III of the classification after NYHA) and the results are compared with those of 30 normal persons. The echocardiographic parameters 'systolic shortening fraction of the left ventricle' (FS), mean circumferential shortening speed of the fibre (mVCF) and the ejection fraction (EF) are suitable for the assessment of the functional condition of the left ventricle. On the basis of these parameters a determination of the degree of severity of the mitral stenosis is not possible, since there are no significant differences between the degrees of severity. The clear restriction of the left ventricular function in mitral stenoses which is partly described in the literature cannot be confirmed. In the two stages the parameters investigated lie widely within the norm. Significant differences in comparison to normal persons can be realized only in the determination of the early diagnostic filling speed of the left ventricle in the two stages.

Adult↗

PubMed1992

[Physical training in coronary patients with poor left ventricular function].

Physical training is beneficial in patients with coronary artery disease, and in those after myocardial infarction in whom left ventricular function and ejection fraction (LVEF) are relatively well preserved. However, little is known about the effect of physical training in coronary patients with impaired left ventricular function. 12 patients after myocardial infarction (range 42-60 years) with LVEF of 30% or less at rest were evaluated after 11 months of isotonic physical training. Mean LVEF increased from 28.0% to 33.0% (p less than 0.002) at rest and from 29.4% to 33.2% (p less than 0.002) on effort. Exercise tolerance increased 228 seconds by the end of the study (p less than 0.001); the double product at symptom limit effort increased (p less than 0.001) and the double product at the same work load decreased (p less than 0.002). During training there was no cardiovascular deterioration and all patients returned to work within a mean of 3.7 months. The results show that patients with severe left ventricular impairment should not necessarily be excluded from cardiac rehabilitation programs involving physical training.

Adult↗

PubMed1996

Pharmacokinetics of intravenous amiodarone in patients with impaired left ventricular function.

To evaluate the potential need for modification of dose regimens of intravenous amiodarone in patients with left ventricular dysfunction, the pharmacokinetics of amiodarone and its active metabolite, desethylamiodarone (DEA), were examined after a single 15-minute intravenous infusion of amiodarone 5 mg/kg. Three parallel groups of otherwise healthy volunteers with normal (n = 12), moderately impaired (ejection fraction > 30 but < or = 45%; n = 6), or severely impaired (ejection fraction < or = 30%; n = 6) left ventricular function were enrolled in the study. Serial blood samples were obtained over a 76-day period for estimation of pharmacokinetic parameters. With the exception of the half-life (t1/2) of DEA, statistical comparisons revealed no significant between-group differences in pharmacokinetic parameters or correlations between pharmacokinetic parameters and ejection fractions. The t1/2 of DEA was increased by approximately 60% in patients with severe left ventricular dysfunction compared with that in patients with moderately impaired and normal left ventricular function. The rate of DEA formation is slow, however, and its concentration relative to amiodarone is low. Therefore, it is unlikely that concentrations of DEA in serum would reach levels that contribute significantly to the pharmacologic activity of amiodarone during short-term (up to 2 weeks) intravenous amiodarone therapy. Single doses of amiodarone were well tolerated. The results of this study suggest that intravenous amiodarone can be used with appropriate observation to control arrhythmias, regardless of the degree of left ventricular dysfunction.

Adult↗

PubMed2005

Effect of transthoracic shocks on left ventricular function.

Although defibrillating shocks are thought to depress ventricular function transiently, the independent effects of high strength shocks (without the metabolic sequelae of pre-shock fibrillation) have not been assessed systematically in humans. Therefore, we delivered three consecutive synchronized monophasic transthoracic shocks (200, 200 and 360 J) at 60s intervals during sinus rhythm and evaluated the effect on left ventricular chamber size and function as determined by transesophageal echocardiography in 11 patients (mean age 67+/-8 years, 9M/2F) with depressed left ventricular function (left ventricular ejection fraction: 14-37%). The shocks did not alter hemodynamics consistently. On average, the shocks did not alter stroke volume, cardiac output, left ventricular ejection fraction or regional wall thickening (all p>0.05 versus baseline). This effect was highly variable and 36% of patients experienced a >25% reduction in cardiac output by the final shock. There was a tendency for regional wall thickening to worsen in the best baseline sextant with an offsetting significant increase in thickening in the worst baseline sextant (p=0.05). Thus, repetitive defibrillation strength transthoracic shocks do not impair left ventricular function consistently in patients with cardiomyopathy. However, the effect is widely variable and potentially important depression of left ventricular function does occur in some patients.

Aged↗

PubMed1980

Detecting abnormalities in left ventricular function during exercise before angina and ST-segment depression.

To determine if abnormalities in left ventricular function precede angina pectoris and electrocardiographic evidence of myocardial ischemia, we used radionuclide angiocardiography to measure left ventricular ejection fraction, volumes, cardiac output and wall motion in 10 normal subjects and 25 patients with coronary artery disease at rest and during two levels of upright bicylce exercise. In the patients with coronary artery disease, the first radionuclide study during exercise was performed before and the second after the onset of ST-segment depression. In all normal subjects, the ejection fraction increased more than 5%, the end-diastolic volume increased less than 25% and the end-systolic volume decreased from rest to both levels of exercise. Wall motion was normal at rest and increased with exercise. No patient with coronary artery disease had chest pain or ST-segment depression during the first level of exercise. The ejection fraction either decreased or increased less than 5% in 18 patients, the end-diastolic volume increased more than 25% in nine, the end-systolic volume increased in 19 and a segmental contraction abnormality developed in 14. Hemodynamic and wall motion abnormalities occurred in all patients during the second level of exercise when ST-segment depression was present. During exercise in patients with coronary artery disease, abnormalities in left ventricular function frequently develop before angina pectoris and electrocardiographic evidence of myocardial ischemia.

Adult↗

PubMed1977

Echocardiographic assessment of left ventricular function. Investigation of infants, children and teenagers without heart disease.

Echocardiography was used to study left ventricular function in 75 infants, children and teenagers without heart disease. Normal values for echocardiographic parameters of left ventricular contractility were obtained and are presented in Tables. Systolic time intervals were measured from aortic cusp echoes and the normal range and correlation to heart rate and age are given. Computer analyses of echocardiograms from the left ventricle and the anterior mitral leaflet were done and normal values for the instantaneous velocities thus derived are given. To test the normal variation of left ventricular function with time 12 children were examined repeatedly during 1 wk. 95% tolerance limits for the variation of the different functional parameters are given. To test the reproducibility of the echocardiographic measurements 11 children with various forms of heart disease were examined consecutively by two different observers and the 95% tolerance limits for the difference between measurements were calculated.

Adolescent↗

PubMed1988

Daily serial evaluation of left ventricular function with equilibrium radionuclide ventriculography following thrombolysis during acute myocardial infarction.

The changes in ventricular function after reperfusion by coronary thrombolysis are important when deciding about further definitive treatment necessary to ensure long-term vessel patency. The purpose of this study was to evaluate the early changes in left ventricular function after reperfusion. Left ventricular function was serially evaluated for 10 days in a group of 18 patients receiving intracoronary thrombolytic therapy for an acute myocardial infarction. Comparison of the global ventricular function in the successfully and unsuccessfully reperfused groups of patients showed significantly better function in the successful group than the unsuccessful group after the first day, which was maintained for the entire study period. Global and regional ventricular function in the successfully reperfused patients showed significant early improvement during the initial 72 h with maintenance of this improvement for the study period of 10 days. In the patients in whom reperfusion was unsuccessful, regional ventricular function showed no change, while the global function declined from day 5 to day 8 of the study period. This study then confirms the significant improvement in ventricular function after successful reperfusion. The time course pattern of the change in ventricular function indicates that the most significant improvement occurs within the first 72 h after reperfusion. These changes are similar to those previously reported in experimental animals.

Angioplasty, Balloon↗

PubMed1989

Bronchial hyperresponsiveness to methacholine in patients with impaired left ventricular function.

To elucidate the pathogenesis of bronchospasm in congestive heart failure, we studied 23 patients with chronic impairment of left ventricular function due to coronary artery disease or dilated cardiomyopathy. In 21 of them we found marked bronchial hyperresponsiveness to methacholine. The mean dose (+/- SD) of methacholine that elicited a 20 percent decrease in the forced expiratory volume in one second (FEV1) was 421 +/- 298 micrograms, nearly the same as in patients with symptomatic asthma. In contrast, there was no bronchial response to methacholine in 9 of 10 patients who had coronary artery disease but normal left ventricular function. Administration of the bronchodilator albuterol led to a partial (43 percent) reversal of the methacholine-induced bronchial obstruction. In 12 patients, pretreatment with the alpha-adrenergic agonist methoxamine (10 mg by inhalation), a potent vasoconstrictor, fully prevented the methacholine-induced decrease in FEV1. The protective effect of methoxamine was blocked by the alpha-adrenergic antagonist phentolamine in all six patients who received this agent. We conclude that bronchial hyperresponsiveness to cholinergic agonists is frequent in patients with impaired left ventricular function and may contribute to the wheezy dyspnea commonly observed in such patients. The bronchoconstriction may be mediated at least in part by dilatation of the bronchial vessels.

Adult↗

PubMed1995

Assessment of left ventricular function in severe scorpion envenomation: combined hemodynamic and echo-Doppler study.

OBJECTIVE: To assess left ventricular function in patients presenting with pulmonary edema following scorpion envenomation. DESIGN: Cohort study. SETTING: Medical intensive care unit of a teaching hospital. PATIENTS: Nine consecutive adult patients stung by Androctonus australis and presenting with pulmonary edema entered the study. Fourteen normal volunteers comprised the control group. INTERVENTIONS: Upon admission, all patients had right heart catheterization and, within the first 8 h, a Doppler echocardiographic study. Results of Doppler echocardiographic studies were compared to those of controls. MEASUREMENTS AND RESULTS: Usual hemodynamic information (heart and vascular pressures, derived data and tissue oxygenation parameters), left ventricular dimensions and indicators of systolic function, and Doppler-derived parameters of left ventricular filling and diastolic function were obtained upon admission. Serial echocardiographic measurements were repeated daily until full clinical recovery (eight patients) or death (one patient). All patients had a hemodynamic profile of acute congestive heart failure (mean PAOP = 24 +/- 2 mmHg; mean SVI = 22 +/- 7 ml/m2; mean CI = 2.5 +/- 0.5 l/min/m2). However, SVR were not increased (mean = 22 +/- 3 U/m2). Left ventricle was hypokinetic in all patients with transient mitral regurgitation present in five patients. Left ventricular systolic function was markedly depressed (FS = 12 +/- 6%; EF = 26 +/- 12%). An associated diastolic dysfunction is suggested by Doppler records of mitral inflow. Left ventricular systolic function evolved toward normalization within 6 +/- 2 days preceded by full clinical recovery. CONCLUSIONS: These data suggest that pulmonary edema in scorpion envenomation is of hemodynamic origin and is related to a severe and prominent impairment of left ventricular systolic function.

Adolescent↗

PubMed2003

Inter-hospital transport for primary angioplasty does not compromise left ventricular function: six-month echocardiographic follow-up of the PRAGUE 1 Study.

The main aim of the present study was to investigate whether long distance interhospital transport for primary angioplasty (delayed mechanical reperfusion) influences the resulting left ventricular function after myocardial infarction as compared with thrombolysis at the nearest hospital (immediate pharmacological reperfusion). Primary coronary angioplasty is more effective than thrombolysis in restoring coronary flow in patients with acute myocardial infarction. It is not known whether a delay in reperfusion due to transport to an angioplasty centre compromises left ventricular function, and whether combination therapy (ie, thrombolysis during transport to an angioplasty centre) would help preserve ejection fraction. The "PRAGUE-1" Study randomised 300 patients with myocardial infarction admitted to community hospitals without a cath-lab into 3 groups: group A (thrombolysis, no transport, n = 99), group B (thrombolysis during transport to an angioplasty centre, n = 100), and group C (transport for primary angioplasty, n = 101). Transport distances were below 75 kilometres, and mean transport time was 38 minutes. This paper presents for the first time the echocardiographic data from the early (discharge, day 30) and mid-term (6 months) follow-up. Only patients who survived until discharge (A: 85, B: 88, C: 94) could be analysed. Ejection fraction improved between discharge and 6 months (P < 0.01) in all three groups: from 47% to 51% in group A, from 47% to 52% in group B, and from 48% to 52% in group C. The differences between the groups were not significant. The same differences were found for the wall motion score index. Left ventricular end-diastolic diameter did not differ between the groups/examinations. Greater improvement was documented in the period between hospital discharge and day 30, compared to the period between day 30 and 6 months. The time delay associated with an inter-hospital transport strategy for primary angioplasty did not compromise left ventricular function. The strategy of thrombolysis during transport did not further improve left ventricular function compared to transport for primary angioplasty alone.

Aged↗

PubMed1984

Sensitivity and specificity of two-dimensional echocardiography in detection of impaired left ventricular function.

The purpose of the study was to determine the sensitivity and specificity of two-dimensional echocardiography (2dE) in the detection of impaired left ventricular function, compared with cineventriculography (CVG). Apical two-dimensional echocardiograms were performed in 110 patients undergoing heart catheterization for the evaluation of clinically suspected coronary heart disease (50 patients), valvular heart disease (38 patients) and congestive cardiomyopathy (22 patients). The left ventricle was scanned in the RAO-equivalent view; cineventriculograms were filmed in the 30 degrees RAO projection. Left ventricular volumes at end-diastole (EDV) and end-systole (ESV) were determined using a disc method; stroke volume (SV) and ejection fraction (EF) were calculated. Based on normal values, the sensitivity, specificity, and predictive accuracy were determined for two-dimensional echocardiography. For EDV, the sensitivity was 80%, specificity 88% and (+) predictive accuracy 86%. The left ventricular ejection fraction was 57.8 +/- 17.2% with CVG and 53.8 +/- 15.6% with 2dE in patients with coronary heart disease, 24.9 +/- 10.5% with CVG and 25.2 +/- 11.1% with 2dE in patients with congestive cardiomyopathy, and 61.1 +/- 13.9% with CVG and 54.2 +/- 9.1% with 2dE in patients with valvular heart disease. Sensitivity was 81%, specificity 100%, and (+) predictive accuracy 100%. The study demonstrates that impaired left ventricular function can be detected by 2dE with high sensitivity and specificity. Thus, 2dE seems to be suitable screening method for evaluation of left ventricular function.

Adult↗

PubMed2000

Limitations of the transpulmonary indicator dilution method for assessment of preload changes in critically ill patients with reduced left ventricular function.

OBJECTIVE: We examined whether intrathoracic blood volume (ITBV) and total end-diastolic volume (TEDV), determined by the transpulmonary indicator dilution technique, adequately reflect preload changes during fluid administration in patients with reduced left ventricular function. DESIGN: A prospective, controlled, clinical study. SETTING: Medical intensive care unit in a university hospital. PATIENTS: A total of 18 sedated, mechanically ventilated, and moderately hypovolemic intensive care unit patients, eight with reduced left ventricular function (ejection fraction area, 24.9+/-8.0%, group A), ten with normal left ventricular function (ejection fraction area, 57.6+/-13.0%, group B). INTERVENTIONS: Continuous crystalloid infusion over 120 mins at a constant rate of 8 mL/kg/30 mins. MEASUREMENTS AND MAIN RESULTS: Stroke volume index, central venous pressure, pulmonary artery occlusion pressure (PAOP), TEDV, and ITBV were determined simultaneously at baseline and serially every 30 mins during continuous crystalloid infusion. A similar series of measurements was obtained during control conditions. Performance of various variables during fluid administration was assessed by time correlation analysis. Sensitivity for various variables defined as the ability to detect increasing amounts of administered fluid in individual patients was calculated. All examined variables increased during fluid administration and were unaffected during the control period. Mean time correlation (r2) was significantly higher for pressure monitoring (central venous pressure, r2 = 0.8281; PAOP, r2 = 0.5476) than for volume variables (TEDV, r2 = 0.0256; ITBV, r2 = 0.0729) in group A and was high for all variables in group B (central venous pressure, r2 = 0.7056; PAOP, r2 = 0.6241; TEDV, r2 = 0.49; ITBV, r2 = 0.4225). Sensitivities for central venous pressure, PAOP, TEDV, and ITBV after 120 min were 63%, 75%, 25%, and 25% in group A and 90%, 100%, 60%, and 60% in group B, respectively. CONCLUSION: This study demonstrates limitations of the transpulmonary indicator dilution technique for monitoring of intravascular volume in patients with reduced left ventricular function.

Critical Care↗

PubMedDate not supplied

Day-to-day variability of global left ventricular functional and perfusional measurements by quantitative gated SPECT using Tc-99m tetrofosmin in patients with heart failure due to coronary artery disease.

BACKGROUND: Although myocardial gated single photon emission computed tomography (SPECT) is routinely used for functional measurements in patients with coronary artery disease (CAD) and heart failure, day-to-day variability of left ventricular ejection fraction (LVEF), left ventricular (LV) volumes, and global perfusion scoring has not yet been investigated. METHODS AND RESULTS: In 20 consecutive patients with CAD and an LVEF lower than 40% who routinely underwent a resting tetrofosmin gated SPECT study, we performed an additional gated SPECT study at rest 1 to 5 days later under the same circumstances. LV volumes and LVEF were calculated from the gated SPECT data by commercially available software (QGS). Myocardial perfusion was scored visually by use of a 20-segment, 5-point scoring method. For global LV function and perfusion, agreement between data was investigated by use of Bland-Altman plotting. The 95% limits of agreement found by Bland-Altman analysis were -0.9% +/- 6.0% for LVEF, 3 +/- 20 mL for LV end-diastolic volume, and 4 +/- 20 mL for LV end-systolic volume. CONCLUSION: In CAD patients with an LVEF lower than 40%, day-to-day variability of measurements of global myocardial function and perfusion is quite similar to interobserver and intraobserver variability. Day-to-day variability of global LV functional parameters obtained by gated cardiac SPECT is fairly small, which indicates that myocardial gated SPECT can be used in daily clinical practice to determine changes in global LV function and perfusion over time in patients with diminished LV function.

Aged↗